COVID-19 and psychosis risk: real or delusional concern?
Open accessAbstract
Historical epidemiological perspectives from past pandemics and recent neurobiological evidence link infections and psychoses, leading to concerns that COVID-19 will present a significant risk for the development of psychosis. But are these concerns justified, or mere sensationalism? In this article we review the historical associations between viral infection and the immune system more broadly in the development of psychosis, before critically evaluating the current evidence pertaining to SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We review the 42 cases of psychosis reported in infected patients to date, and discuss the potential implications of in utero infection on subsequent neurodevelopment and psychiatric risk. Finally, in the context of the wider neurological and psychiatric manifestations of COVID-19 and our current understanding of the aetiology of psychotic disorders, we evaluate possible neurobiological and psychosocial mechanisms as well as the numerous challenges in ascribing a causal pathogenic role to the infection.
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We observed a significantly increased risk of psychotic disorders after COVID-19.
“Unlike the earlier study, and in line with previous suggestions,28 we also observed a significantly increased risk of psychotic disorders, probably reflecting the larger sample size and longer duration of follow-up reported here.”
From 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records (2021) · cites this paper as [28]
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Taquet, M., Geddes, J. R., Husain, M., Luciano, S., & Harrison, P. J. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00084-5 · Cited by 2,189 · see citing works
“Unlike the earlier study, and in line with previous suggestions, 28 we also observed a significantly increased risk of psychotic disorders, probably reflecting the larger sample size and longer duration of follow-up reported here.”
- Authors
- Watson, C. J., Thomas, R. H., Solomon, T., Michael, B. D., Nicholson, T. R., & Pollak, T. A.
- Affiliations
- Queen Mary University of London (GB)
- Royal Victoria Infirmary (GB)
- University of Liverpool (GB)
- King's College London (GB)
- Corresponding author
- Watson, Cameron J.
- ORCID
- Venue
- Neuroscience Letters
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 741
- Pages
- 135491
- ISSN
- 0304-3940 (ISSN-L)
- OpenAlex
- W3098670568
- Cited by
- 103
- References
- 98
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 10 · 2023: 20 · 2022: 30 · 2021: 37
- FWCI
- 8.64
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Neuroscience Letters (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute for Health Research (IS-HPU-1112−10117)
- Wellcome
- Horizon 2020 (734584)
- UK Research and Innovation
- Medical Research Council
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- COVID-19 pandemic, psychosis, SARS-CoV-2, post-infectious psychosis, intrauterine infection, brain development, psychiatric risk, neurobiological mechanisms, psychosocial mechanisms, causal inference, history of pandemics, immune system
- MeSH terms
- COVID-19, Adolescent, Adult, Delusions, Female, Humans, Male, Middle Aged, Psychotic Disorders, Risk Factors, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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